The indigent, multi-ethnic populations who use the emergency rooms of urban hospitals in our country as their sole source of medical care are seldom exposed to opportunities for preventive medical services including early cancer detection. Paradoxically, low- income populations are at highest risk of many cancers, including cervical cancer. The social, cultural, economic and political factors associated with inadequacies in their medical and preventive care are numerous and insurmountable in the short term. In the case of cervical cancer, however, we have shown in an NCI- funded pilot study, that it is feasible to bypass the underlying lack of a preventive orientation in this population by providing Pap smear screening as part of routine acute care in the Emergency Department (ED) of Highland General Hospital (HGH), Oakland. The current proposal is based on this innovation and will take the next step along the pathway to an effective program of cervical cancer screening. In two randomized, controlled substudies we will: (1) develop, implement, and evaluate the effectiveness of a specialized Cancer Awareness, Referral, and Education (CARE) Clinic compared to routine Gynecology Clinic follow-up for women with abnormal ED Pap smears; and (2) develop, implement, and evaluate a program designed to encourage women with normal ED Pap smears to return for periodic screening at recommended intervals. These interventions reflect innovations in procedural and organizational aspects of health care delivery within the county health care system.